Operate, actions
Actions
Downstream actions derived from the resolved identities. Proposed actions wait for an operator; suppressed actions wait for a steward decision.
Eligibility engine
1,339
Eligibility conflict resolved
1,339 proposed
Claims processor
9,112
Orphan claim re-pointed
9,112 executed
Outreach
7,319
Outreach address corrected, Outreach suppressed pending steward
2,993 proposed4,326 held
Next-best-action
3,896
Care coordination outreach, New member onboarding
3,896 proposed
Member services
4,974
Duplicate member record retired
4,974 executed
Actions
26,640 derived from the last resolution run
| Action | Type | Title | Detail | Linked to | Status | Executed | |
|---|---|---|---|---|---|---|---|
| ACT-000701 | Eligibility conflict resolved Eligibility engine | Brittany Hawkins: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000702 | Eligibility conflict resolved Eligibility engine | Raymond Armstrong: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000703 | Eligibility conflict resolved Eligibility engine | Mariana Meyer: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000704 | Eligibility conflict resolved Eligibility engine | Nancy Castillo: 3 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000705 | Eligibility conflict resolved Eligibility engine | Karen Welch: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000706 | Eligibility conflict resolved Eligibility engine | Andrea Bryant: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000707 | Eligibility conflict resolved Eligibility engine | Marcus Richards: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000708 | Eligibility conflict resolved Eligibility engine | Jeffrey Cook: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000709 | Eligibility conflict resolved Eligibility engine | Ruth Meyer: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000710 | Eligibility conflict resolved Eligibility engine | Carolyn Wallace: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000711 | Eligibility conflict resolved Eligibility engine | Diego Ramos: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000712 | Eligibility conflict resolved Eligibility engine | Jacob Pierce: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000713 | Eligibility conflict resolved Eligibility engine | Donald Payne: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000714 | Eligibility conflict resolved Eligibility engine | Kayla Knight: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000715 | Eligibility conflict resolved Eligibility engine | Ahmed Wells: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000716 | Eligibility conflict resolved Eligibility engine | Michelle Jensen: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000717 | Eligibility conflict resolved Eligibility engine | Roger Reid: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000718 | Eligibility conflict resolved Eligibility engine | Jose Roberts: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000719 | Eligibility conflict resolved Eligibility engine | Keith Brooks: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000720 | Eligibility conflict resolved Eligibility engine | Kimberly Lawson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000721 | Eligibility conflict resolved Eligibility engine | Nancy Andrews: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000722 | Eligibility conflict resolved Eligibility engine | Jeremy Nguyen: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000723 | Eligibility conflict resolved Eligibility engine | Margaret Gutierrez: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000724 | Eligibility conflict resolved Eligibility engine | Melissa Gardner: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000725 | Eligibility conflict resolved Eligibility engine | Sharon Day: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000726 | Eligibility conflict resolved Eligibility engine | Charles Taylor: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000727 | Eligibility conflict resolved Eligibility engine | Alexis Hunt: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000728 | Eligibility conflict resolved Eligibility engine | Bruce Wilson: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000729 | Eligibility conflict resolved Eligibility engine | Kimberly Ryan: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000730 | Eligibility conflict resolved Eligibility engine | Christopher Guerrero: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000731 | Eligibility conflict resolved Eligibility engine | Sarah Ward: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000732 | Eligibility conflict resolved Eligibility engine | Aaron Bailey: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000733 | Eligibility conflict resolved Eligibility engine | Elijah Fields: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000734 | Eligibility conflict resolved Eligibility engine | Albert Espinoza: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000735 | Eligibility conflict resolved Eligibility engine | Melissa Cruz: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000736 | Eligibility conflict resolved Eligibility engine | Jerry Dean: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000737 | Eligibility conflict resolved Eligibility engine | Juan Richards: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000738 | Eligibility conflict resolved Eligibility engine | Harold Tran: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000739 | Eligibility conflict resolved Eligibility engine | Ashley Cox: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000740 | Eligibility conflict resolved Eligibility engine | Lisa Soto: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000741 | Eligibility conflict resolved Eligibility engine | Angela Garrett: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000742 | Eligibility conflict resolved Eligibility engine | Beverly Hunter: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000743 | Eligibility conflict resolved Eligibility engine | Nancy Wheeler: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000744 | Eligibility conflict resolved Eligibility engine | Arthur Kelley: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000745 | Eligibility conflict resolved Eligibility engine | Anna Lawrence: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000746 | Eligibility conflict resolved Eligibility engine | Carolyn Wong: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000747 | Eligibility conflict resolved Eligibility engine | Jesse Hernandez: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000748 | Eligibility conflict resolved Eligibility engine | Angela Espinoza: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000749 | Eligibility conflict resolved Eligibility engine | Nick Garrett: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000750 | Eligibility conflict resolved Eligibility engine | Alexander Ray: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — |
Derivation rules
Evaluated after every gold rebuild
- 1Eligibility conflict resolvedThe records behind one identity disagree on plan code. Survivorship picks the enrollment plan; the eligibility engine is told which one is canonical.
- 2Orphan claim re-pointedA claim arrived without a member ID. Resolution attached it to an identity that has one, so the claims processor can now pay it against the right member.
- 3Outreach address correctedThe most recent address on the golden record differs from what enrollment holds. Outreach gets the current address before the next mailing.
- 4Outreach suppressed pending stewardThe record is sitting in an open steward case. Nothing sensitive is sent until a person decides, so we never message the wrong member.
- 5Care coordination outreachThree or more claims and no provider record. Next-best-action proposes assigning a PCP and scheduling a care-coordination call.
- 6New member onboardingA single, fresh enrollment with no other activity yet. Next-best-action proposes the welcome kit and a digital ID card.
- 7Duplicate member record retiredTwo or more enrollment records collapsed into one identity. Member services retires the extra cards against the surviving member ID.